Paul: Trump backs health repeal, replacement at same time

WASHINGTON (AP) — A Republican senator who challenged Donald Trump for the White House nomination says the president-elect "fully supports" repealing President Barack Obama's health law only when there's a viable alternative to replace it.

Republican leaders in the GOP-controlled Congress are moving toward a vote on repeal legislation in coming weeks, but they anticipate a transition period of months or years to a replacement. Some Republican lawmakers are expressing reservations about scrapping the law, which now covers 20 million people, without a near-term replacement.

Kentucky Sen. Rand Paul, who clashed with Trump during the GOP primary, said in a tweet late Friday that the two had a conversation and that Trump agreed with Paul's approach.

"I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it," Paul tweeted. "The time to act is now."

Trump aides did not immediately respond questions about the conversation and how it had come about.

Nothing about revamping the nation's $3 trillion-a-year health care system will come easy, but GOP leaders want congressional committees to have legislation dismantling much of Obama's overhaul ready by late January. They're hoping Congress can quickly send a measure to the incoming president that would phase out the law, perhaps a couple of months later.

Crafting a GOP replacement probably will take more time, thanks to Republican divisions and solid Democratic opposition. It would be a political nightmare for Republicans to repeal the Affordable Care Act and then fail to pass a new version of the law.

Sen. Bob Corker, R-Tenn., told reporters Friday that Republicans might find themselves in a "box canyon" if they erase the law without a substitute in hand.

One part of Obama's law Republicans are eager to repeal is its tax increases on higher-earning people and segments of the health care industry that help finance expanded coverage. Corker said that if those taxes are voided but Republicans temporarily continue subsidies to help people buy coverage, "that means Republicans would have to vote for a tax increase" to pay for them — usually a non-starter for the GOP.

Sen. Ron Johnson, R-Wis., said Friday that if he had his way, "I would start bringing up those elements that start repairing the damage and I would start taking votes on those right now."

Republicans probably will need just a simple Senate majority to approve their repeal bill, but for procedural reasons, later replacement legislation likely will need 60 votes. Republicans now hold a 52-48 edge in the Senate. That means a need for at least eight Democratic votes, though there will be pressure on 10 Democrats facing re-election next year from states Trump won in November.

"I take Minority Leader Schumer at his word that if we do this we're not going to get any Democratic support. In order to actually pass a replacement, we need Democratic support," Johnson told reporters.

After repeatedly trying to repeal Obama's law since its 2010 enactment, Republicans are under tremendous pressure from their voters to annul it swiftly.

But GOP leaders have talked about their repeal not taking effect for perhaps two or three years. They're discussing providing some type of revenue during that period to maintain coverage for people and perhaps for insurers so they won't immediately abandon markets.

Sen. Tom Cotton, R-Ark., also called this week for a simultaneous effort to erase the health care law and rewrite it.

"I don't think we can just repeal Obamacare and say we're going to get an answer two years from now," Cotton said Thursday on MSNBC.

He added, "We haven't coalesced around a solution for six years, in part because it is so complicated. Kicking the can down the road for a year or two years isn't going to make it any easier to solve."